Owner of Houston Home Health Agency Sentenced to 80 Yrs for Involvement in $13 Million Medicare Fraud

Owner of Home Health Agency Sentenced in Absentia to 80 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy and for Filing Fraudulent Tax Returns

U.S. Department of Justice press release Dec. 8, 2017                                                                             

The owner of a Houston home health agency was sentenced today to 80 years in prison for his role in a $13 million Medicare fraud scheme and for filing false tax returns.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Region and Special Agent in Charge D. Richard Goss of the Houston Field Office of the Internal Revenue Service Criminal Investigation (IRS-CI) made the announcement.

Ebong Tilong, 53, of Sugarland, Texas, was sentenced by U.S. District Judge Melinda Harmon of the Southern District of Texas. In November 2016, after the first week of trial, Tilong pleaded guilty to one count of conspiracy to commit healthcare fraud, three counts of healthcare fraud, one count of conspiracy to pay and receive healthcare kickbacks, three counts of payment and receipt of healthcare kickbacks, and one count of conspiracy to launder monetary instruments. In June 2017, Tilong pleaded guilty to two counts of filing fraudulent tax returns. Tilong failed to appear for his original sentencing, which was scheduled for Oct. 13, 2017.

According to the evidence presented at trial and Tilong’s admissions in connection with his guilty plea, from February 2006 through June 2015, Tilong and others conspired to defraud Medicare by submitting over $10 million in false and fraudulent claims for home health services to Medicare through Fiango Home Healthcare Inc. (Fiango), owned by Tilong and his wife, Marie Neba, 53, also of Sugarland, Texas. The trial evidence showed that using the money that Medicare paid for such fraudulent claims, Tilong paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries to Fiango for home health services. Tilong also paid illegal kickbacks to Medicare beneficiaries for allowing Fiango to bill Medicare using beneficiaries’ Medicare information for home health services that were not medically necessary or not provided, the evidence showed. Tilong falsified medical records and directed others to falsify medical records to make it appear as though the Medicare beneficiaries qualified for and received home health services. Tilong also attempted to destroy evidence, blackmail a witness, and suborn perjury from witnesses, including a co-defendant while in the federal courthouse, the evidence showed.

According to the evidence presented at trial and his admissions to the tax offenses, from February 2006 to June 2015, Tilong received more than $13 million from Medicare for home health services that were not medically necessary or not provided to Medicare beneficiaries.

In connection with his guilty plea to the tax offenses, Tilong admitted that to maximize his gains from the Medicare fraud scheme, he created a shell company called Quality Therapy Services (QTS) to limit the amount of tax that he paid to the IRS on the proceeds that he and his co-conspirators stole from Medicare. According to his plea agreement, in 2013 and 2014, Tilong wrote almost a million dollars in checks from Fiango to QTS, purportedly for physical-therapy services that QTS provided to Fiango’s Medicare patients. The evidence showed that QTS did not provide those services. According to his plea agreement, in 2013 and 2014, Tilong’s fraudulent tax scheme caused the IRS a tax loss of approximately $344,452.

To date, four others have pleaded guilty or been convicted based on their roles in the fraudulent Medicare scheme at Fiango. Nirmal Mazumdar, M.D., of Houston, Texas, the former medical director of Fiango, pleaded guilty to a scheme to commit health care fraud for his role at Fiango. Daisy Carter, 58, of Wharton, Texas, and Connie Ray Island, 49, of Houston, Texas, two patient recruiters for Fiango, pleaded guilty to conspiracy to commit health care fraud for their roles at Fiango. Neba was convicted after a two-week jury trial of one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, one count of payment and receipt of health care kickbacks, one count of conspiracy to launder monetary instruments and one count of making health care false statements.

On Aug. 11, Neba was sentenced to 75 years in prison and Island was sentenced to 33 months in prison. On Oct. 3, Mazumdar was sentenced to time served with three years of home confinement. Carter is awaiting sentencing.

The case was investigated by the FBI, IRS-CI and HHS-OIG under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas. The case is being prosecuted by Trial Attorney William S.W. Chang, Senior Trial Attorney Jonathan T. Baum, and Trial Attorney Andrew Pennebaker of the Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Feds Sue Springfield, Illinois for Discrimination Against Persons with Disabilities

Nov. 28, 2017 -- The Justice Department today filed a lawsuit alleging that the City of Springfield, Illinois, has discriminated against persons with disabilities in violation of the Fair Housing Act. The lawsuit, filed in the U.S. District Court for the Central District of Illinois, alleges that Springfield’s zoning code treats small group homes for persons with disabilities less favorably than similarly-situated housing for people without disabilities. The department’s complaint further alleges that, even if the zoning code were valid, Springfield violated the Fair Housing Act by failing to grant an exception that would allow a three-person group home for individuals with disabilities to continue operating in a residential neighborhood.

“The Fair Housing Act prohibits cities from applying their zoning laws in a manner that discriminates against persons with disabilities,” said Acting Assistant Attorney General John Gore of the Civil Rights Division. “We will continue to vigorously enforce the Fair Housing Act’s prohibition on such discrimination.”

This case arose when the City of Springfield attempted to close a home with three residents with intellectual and physical disabilities because the home violated a 600-foot spacing requirement that applies to community residences for persons with disabilities. That spacing requirement does not apply to homes for up to five unrelated persons without disabilities. The small group home allowed two of the residents to move out of large institutions and live in an integrated community setting.

The lawsuit seeks a court order prohibiting Springfield from enforcing the spacing requirement against this home or similarly-situated homes for persons with disabilities elsewhere in the city. The lawsuit also seeks monetary damages to compensate victims, as well as payment of a civil penalty. A related case challenging Springfield’s spacing requirement was filed by the home’s service provider and one resident. The court in that case, A.D. ex rel. Valencia v. City of Springfield, issued a preliminary injunction against Springfield on Aug. 2, 2017. That ruling is now on appeal to the U.S. Court of Appeals for the Seventh Circuit.

The federal Fair Housing Act prohibits discrimination in housing based on disability, race, color, religion, national origin, sex, and familial status. More information about the Civil Rights Division and the laws it enforces is available at www.justice.gov/crt. Individuals who believe that they may have been victims of housing discrimination can call the Justice Department at 1-800-896-7743, e-mail the Justice Department at fairhousing@usdoj.gov(link sends e-mail), or contact the Department of Housing and Urban Development at 1-800-669-9777 or through its website at https://www.hud.gov/program_offices/fair_housing_equal_opp.

The complaint is an allegation of unlawful conduct. The allegations must still be proven in federal court.

SOURCE: Justice Department press release

Former Massachusetts Police Sergeant Sentenced to Prison for Embezzling Funds from Disabled Veterans

Department of Justice

Nov. 14, 2017 - A former Whitman, Massachusetts, police sergeant was sentenced to 48 months in prison today for preparing false income tax returns for clients of his tax preparation business, obstructing the internal revenue laws, and misappropriating funds from the accounts of disabled veterans while he was a fiduciary appointed by the U.S. Department of Veterans Affairs (VA), announced Acting Deputy Assistant Attorney General Stuart M. Goldberg of the Department of Justice’s Tax Division and Acting U.S. Attorney William D. Weinreb for the District of Massachusetts.

According to documents filed with the Court, from 2007 to 2012, Glenn P. Pearson, 61, was appointed a VA fiduciary for eight disabled veterans of the U.S. armed forces. A veteran, who has been awarded VA benefits but is unable to manage his or her funds due to injury, disease, mental incompetence or infirmities of advanced age, can have a fiduciary appointed by the VA to receive funds on the veteran’s behalf and to manage those funds for the benefit of the veteran. Pearson used his position as a fiduciary to embezzle more than $250,000 in VA-issued benefit money from the accounts of several veterans.

Moreover, beginning in 2012, Pearson operated FTS Tax Services, a tax preparation business through which he prepared false tax returns for clients for a fee. From 2012 through 2015, Pearson prepared numerous tax returns that included false credits and fictitious deductions in an effort to obtain bigger refunds for his clients than they were entitled to receive. When Pearson’s clients were audited by the Internal Revenue Service (IRS), Pearson took steps to obstruct the IRS—including making false statements to the IRS and preparing false documents for his clients to submit to the IRS during the audits. Pearson also falsely underreported his own income on his personal federal income tax returns. Pearson admitted to causing a total tax loss of more than $1.5 million.

In addition to the term of prison imposed, Chief United States District Judge Patti B. Saris ordered Pearson to serve three years of supervised release and to pay restitution to the VA in the amount of $252,992 and restitution to the IRS in the amount of $826,865. Pearson pleaded guilty in May to wire fraud, misappropriation by a federal fiduciary, preparation of fraudulent tax returns and obstructing the internal revenue laws.

Acting Deputy Assistant Attorney General Goldberg and Acting U.S. Attorney Weinreb thanked special agents of IRS Criminal Investigation, FBI and VA–OIG, who conducted the investigation, and Assistant U.S. Attorney Vassili Thomadakis and Assistant Chief Karen Kelly of the Tax Division, who prosecuted the case.

Additional information about the Tax Division’s enforcement efforts can be found on the division’s website.

source: DOJ press release                                                                                                                  

Understanding Your Employment Rights Under the Americans with Disabilities Act (ADA): A Guide for Veterans

Introduction

In recent years, the percentage of veterans who report having service-connected disabilities (i.e., disabilities that were incurred in, or aggravated during, military service)[1] has risen. About twenty-nine percent of recent veterans report having a service-connected disability, as compared to about thirteen percent of all veterans.[2] Common injuries experienced by veterans include missing limbs, spinal cord injuries, burns, post traumatic stress disorder (PTSD), hearing loss, traumatic brain injuries, and other impairments. Other veterans leave service due to injuries or conditions that are not considered service-connected.

This Equal Employment Opportunity Commission (EEOC) guide is intended to answer questions you may have about your rights as an injured veteran, now that you have left the service and are returning to a civilian job or seeking a new job. It also explains the kinds of adjustments (called reasonable accommodations) that may help you be successful in the workplace.

1. Are there any laws that protect veterans with disabilities in employment?

Yes. There are several federal laws that provide important protections for veterans with disabilities who are looking for jobs or are already in the workplace. Two of those laws --the Uniformed Services Employment and Reemployment Rights Act (USERRA) and Title I of the Americans with Disabilities Act (ADA) - protect veterans from employment discrimination. See Qs&As 6 and 7 for a discussion of laws providing veterans' preference and special hiring for veterans.

USERRA has requirements for reemploying veterans with and without service-connected disabilities and is enforced by the U.S. Department of Labor (DOL) and the Department of Justice (DOJ). Title I of the ADA, which is enforced by the U.S. Equal Employment Opportunity Commission (EEOC), prohibits private and state and local government employers with 15 or more employees from discriminating against individuals on the basis of disability.[3] Any veteran with a disability who meets the ADA's definition is covered, regardless of whether the veteran's disability is service-connected.

2. What does USERRA do?

USERRA prohibits employers from discriminating against employees or applicants for employment on the basis of their military status or military obligations. It also protects the reemployment rights of individuals who leave their civilian jobs (whether voluntarily or involuntarily) to serve in the uniformed services, including the U.S. Reserve forces and state, District of Columbia, and territory (e.g., Guam) National Guards.

Under USERRA, employers must make "reasonable efforts" to help a veteran who is returning to employment to become qualified to perform the duties of the position he or she would have held but for military service whether or not the veteran has a service-connected disability. If the veteran has a disability incurred in, or aggravated during, his or her service, the employer must make reasonable efforts to accommodate the disability and return the veteran to the position in which he or she would have been employed if the veteran had not performed military service. If the veteran is not qualified for that position due to the disability, USERRA requires the employer to make reasonable efforts to help qualify the veteran for a job of equivalent seniority, status, and pay, the duties of which the person is qualified to perform or could become qualified to perform. This could include providing training or retraining for the position at no cost to the veteran. See Title 38, United States Code, Chapter 43 - Employment and Reemployment Rights of Members of the Uniformed Services, 38 U.S.C. § 4313; 20 C.F.R. §§ 1002.198, 1002.225 -.226. USERRA applies to all veterans, not just those with service-connected disabilities, and to all employers regardless of size. For more information on the reemployment rights of uniformed service personnel, see DOL's website at www.dol.gov/vets.

3. What protections does the ADA provide?

Title I of the ADA prohibits an employer from treating an applicant or employee unfavorably in all aspects of employment -- including hiring, promotions, job assignments, training, termination, and any other terms, conditions, and privileges of employment -- because he has a disability, a history of having a disability, or because the employer regards him as having a disability. That means, for example, that it is illegal for an employer to refuse to hire a veteran because he has PTSD, because he was previously diagnosed with PTSD, or because the employer assumes he has PTSD. The ADA also limits the medical information employers may obtain and prohibits disability-based harass­ment and retaliation.

Finally, the ADA provides that, absent undue hardship (significant difficulty or expense to the employer), applicants and employees with disabilities are entitled to reasonable accommodation to apply for jobs, to perform their jobs, and to enjoy equal benefits and privileges of employment (e.g., access to the parts of an employer's facility available to all employees and access to employer-sponsored training and social events).

Section 501 of the Rehabilitation Act applies the same standards of non-discrimination and reasonable accommodation as the ADA to Federal Executive Branch agencies and the United States Postal Service. Documents explaining Title I of the ADA and the Rehabilitation Act can be found on EEOC's website at www.eeoc.gov.

4. I was injured during active duty but don't think of myself as "disabled." How do I know if I am protected by the ADA?

You are protected if you meet the ADA's definition of disability and are qualified for the job you want or hold. The ADA defines an "individual with a disability" as a person who (1) has a physical or mental impairment that substantially limits one or more major life activities; (2) has a record of such an impairment (i.e. was substantially limited in the past, such as prior to undergoing rehabilitation); or (3) is regarded, or treated by an employer, as having such an impairment, even if no substantial limitation exists. You are considered qualified if you are able to meet an employer's requirements for the job, such as education, training, employment experience, skills, or licenses, and are able to perform the job's essential or fundamental duties with or without reasonable accommodation.

As a result of changes to the ADA made by the ADA Amendments Act of 2008, it is now much easier for individuals with a wide range of impairments to establish that they are individuals with disabilities and entitled to the ADA's protections. For example, the term "major life activities" includes not only activities such as walking, seeing, hearing, and concentrating, but also the operation of major bodily functions, such as functions of the brain and the neurological system.[4]

Additionally, an impairment need not prevent or severely or significantly restrict your performance of a major life activity to be considered substantially limiting; the determination of whether an impairment substantially limits a major life activity must be made without regard to any mitigating measures (e.g., medications or assistive devices, such as prosthetic limbs) that you may use to lessen your impairment's effects; and impairments that are episodic or in remission (e.g., epilepsy or PTSD) are considered disabilities if they would be substantially limiting when active.[5] Some service-connected disabilities, such as deafness, blindness, partially or completely missing limbs, mobility impairments requiring the use of a wheelchair, major depressive disorder, and PTSD, will easily be concluded to be disabilities under the ADA.[6]

5. If I have a military disability rating or a disability rating from the VA, does that mean I am also covered by the ADA?

Yes, you are probably covered. Although the ADA uses different standards than the U.S. Department of Defense and the U.S. Department of Veterans Affairs (VA) in determining disability, many more service-connected disabilities will also be considered disabilities under the ADA than prior to the ADA Amendments Act. See Q&A 4.

6. Under the ADA, is a private employer required to hire me over other applicants because I have a disability?

Though it is not required to do so, a private employer may decide to give a veteran with a disability a preference in hiring. The ADA prohibits discrimination "on the basis of disability." This means that if you are qualified for a job, an employer cannot refuse to hire you because you have a disability or because you may need a reasonable accommodation to perform the job. Even if you are qualified for a job, an employer may choose another applicant without a disability because that individual is better qualified.

Some laws, however, require private employers to give a preference to veterans with disabilities. For example, the Vietnam Era Veteran's Readjustment Assistance Act (VEVRAA) requires that businesses with a federal contract or subcontract in the amount of $100,000 or more, entered into on or after December 1, 2003, take affirmative action to employ and advance qualified disabled veterans. VEVRAA also requires these businesses to list their employment openings with the appropriate employment service and to give covered veterans priority in referral to such openings.[7]

7. Are there any laws that will give me special consideration if I am looking for a job with the federal government?

Yes. Under the Veterans Preference Act, veterans with and without disabilities are entitled to preference over others in hiring from competitive lists of eligible applicants and may be considered for special noncompetitive appointments for which they are eligible.[8]

Federal agencies also may use specific rules and regulations, called "special hiring authorities," to hire individuals with disabilities outside the normal competitive hiring process, and sometimes may even be required to give preferential treatment to veterans, including disabled veterans, in making hiring decisions.

Here are some of the special hiring authorities that may apply to you if you are looking for a job with the federal government:

• The Veterans' Recruitment Appointment (VRA) program allows agencies to appoint eligible veterans without competition.
• The Veterans Employment Opportunity Act (VEOA) can be used when filling permanent, competitive service positions. It allows veterans to apply for jobs that are only open to "status" candidates, which means "current competitive service employees."
• The Schedule A Appointing Authority, though not specifically for veterans, allows agencies to appoint eligible applicants who have a severe physical, psychological, or intellectual disability.

For more information on veterans' preferences and special hiring authorities, see the "Vet Guide" on the U.S. Office of Personnel Management (OPM) website at www.opm.gov/staffingportal/vetguide.asp#intro, "Feds Hire Vets - Veterans' Preference" at www.fedshirevets.gov/job/vetpref/index.aspx, and Special Hiring Authorities for Veterans at www.fedshirevets.gov/job/shav/index; see also OPM's Disabled Veterans Affirmative Action Program at www.opm.gov/veterans/dvaap.asp.

8. During a job interview, may an employer ask about my amputation, why I am in a wheelchair, or how I sustained any other injury I may have?

No. Even if your disability is obvious, an employer cannot ask questions about when, where, or how you were injured. However, where it seems likely that you will need a reasonable accommodation to do the job, an employer may ask you if an accommodation is needed and, if so, what type. In addition, an employer may ask you to describe or demonstrate how you would perform the job with or without an accommodation. For example, if the job requires that you lift objects weighing up to 50 pounds, the employer can ask whether you will need assistance or ask you to demonstrate how you will perform this task. Similarly, if you voluntarily reveal that you have an injury or illness and an employer reasonably believes that you will need an accommodation, it may ask what accommodation you need to do the job.

9. Do I have to disclose an injury or illness that is not obvious during an interview or indicate on a job application that I have a disability?

No. The ADA does not require you to disclose that you have any medical condition on a job application or during an interview. However, if you will need a reasonable accommodation to participate in the application process, such as more time to take a test or permis­sion to provide oral instead of written responses, you must request it. Additionally, some veterans with service-connected disabilities may choose to disclose that they have medical conditions, such as PTSD or a traumatic brain injury, because of symptoms they experience or because they will need a reasonable accommodation at work. Once an employer makes a job offer, it may ask you questions about your medical conditions, and perhaps even require you to take a medical examination, as long as it requires everyone else in the same job to answer the same questions and/or take the same medical examination before starting work.

10. Some applications ask me to indicate whether I am a "disabled veteran." Is this legal?

Yes, if the information is being requested for affirmative action purposes. See EEOC Enforcement Guidance: Preemployment Disability-Related Questions and Medical Examinations Under the Americans with Disabilities Act of 1990 (1995) at www.eeoc.gov/policy/docs/preemp.html. An employer may ask applicants to voluntarily self-identify as individuals with disabilities or "disabled veterans" when the employer is: (1) undertaking affirmative action because of a federal, state, or local law (including a veterans' preference law) that requires affirmative action for individuals with disabilities; or (2) voluntarily using the information to benefit individuals with disabilities, including veterans with service-connected disabilities.

If an employer invites you to voluntarily self-identify as a disabled veteran, it must clearly inform you in writing (or orally, if no written questionnaire is used) that: (1) the information is being requested as part of the employer's affirmative action program; (2) providing the information is voluntary; (3) failure to provide it will not subject you to any adverse treatment; and (4) the information will be kept confidential and only used in a way that complies with the ADA.

11. What types of reasonable accommodations may I want to request for the application process or on the job?

The following are examples of types of accommodations that you may need for the application process or while on the job:

• written materials in accessible formats, such as large print, Braille, or on computer disk
• extra time to complete a test if you have difficulty concentrating or have a learning disability or traumatic brain injury (TBI)
• interviews, tests, and training held in accessible locations
• modified equipment or devices (e.g., assistive technology that would allow you to use a computer if you are blind or to use a telephone if you are deaf or hard of hearing; a glare guard for a computer monitor if you have a TBI; a one-handed keyboard if you are missing an arm or hand)
• physical modifications to the workplace (e.g., reconfiguring a workspace, including adjusting the height of a desk or shelves if you use a wheelchair)
• permission to work from home
• leave for treatment, recuperation, or training related to your disability
• a modified or part-time work schedule
• a job coach who could assist you if you initially have some difficulty learning or remembering job tasks
• modification of supervisory methods, such as having a supervisor break complex assignments into smaller, separate tasks, provide some additional feedback or guidance on a task, or adjust methods of communication (e.g., give written rather than oral instructions for completing certain tasks)
• reassignment to a vacant position if your disability prevents you from performing the duties of your current position or where any reasonable accommodation in your current position would result in undue hardship (i.e., significant difficulty or expense)

12. How do I ask for a reasonable accommodation?

You simply have to indicate -- orally or in writing -- that you need an adjustment or change in the application process or at work for a reason related to a medical condition. For example, if you have a vision loss and cannot read standard print, you would need to inform the employer that you need the application materials in some other format (e.g., large print or on computer disk) or read to you. You do not have to mention the ADA or use the term "reasonable accommodation." Someone acting on your behalf, such as a family member, rehabilitation counselor, health professional, or other representative, also can make the request.

13. What happens after I request a reasonable accommodation?

A request for reasonable accommodation is the first step in an informal interactive process between you and the employer.

The process will involve determining whether you have a disability as defined by the ADA (where this is not obvious or already known) and identifying accommodation solutions. An employer also may ask if you know what accommodation you need that will help you apply for or do the job. There are extensive public and private resources to help identify reasonable accommodations for applicants and employees with particular disabilities. For example, the website for the Job Accommodation Network (JAN) provides a practical guide for individuals with disabilities on requesting and discussing reasonable accommodations and on finding the right job. See JAN's website at www.askjan.org.

14. I am not sure whether I will need a reasonable accommodation. If I don't ask for one before I start working, can I still ask for one later?

Yes. You can request an accommodation at any time during the application process or when you start working even if you did not ask for one when applying for a job or after receiving a job offer. If you are already receiving a reasonable accommodation, you may also request a different or additional accommodation later if your disability and/or the job changes, or if another accommodation becomes available that will help you.

Generally, you should request an accommodation when you know that there is a workplace barrier that is preventing you from competing for or performing a job or having equal access to the benefits of employment. As a practical matter, it is better to request a reasonable accommodation before your job performance suffers.

15. What can I do if I feel that an employer has violated the ADA by not hiring me or providing a reasonable accommodation?

If you believe that your employment rights have been violated on the basis of disability (or for some other discriminatory reason), there are actions you can take:

• Claims against a private or a state or local government employer:To take formal action, you must file a charge of discrimination with the EEOC. The charge must be filed by mail or in person with the local EEOC office within 180 days from the date of the alleged violation. The 180-day filing deadline is extended to 300 days if a state or local anti-discrimination law also covers the charge.
  The EEOC will send you and the employer a copy of the charge and may ask for responses and supporting information. Before a formal investigation, the EEOC may select the charge for EEOC's mediation program. Mediation is free, confidential, and voluntary for both parties. A charge will only be mediated if both parties agree to participate in the process. Mediation may prevent a time-consuming investigation of the charge.
  If a charge goes to mediation but is unsuccessful or is not selected for mediation, the EEOC investigates the charge to determine if there is "reasonable cause" to believe discrimination has occurred. If reasonable cause is found, the EEOC will then try to resolve the charge with the employer. In some cases, where the charge cannot be resolved, the EEOC will file a court action. If the EEOC finds no discrimination, or if an attempt to resolve the charge fails and the EEOC decides not to file suit, it will issue you a notice of a "right to sue," which will give you 90 days to file a court action. You also can request a notice of a "right to sue" from the EEOC 180 days after the charge first was filed with the EEOC and may then bring suit within 90 days after receiving the notice.

For a detailed description of the process, visit our website at www.eeoc.gov/charge/overview_charge_filing.html.

• Claims against a federal government agency: If you are a federal employee or applicant and you believe that a federal agency has discriminated against you, you have a right to file a complaint. Each agency is required to post information about how to contact the agency's EEO Office. You can contact an EEO Counselor by calling the office responsible for the agency's EEO complaints program.
  The first step is to contact an EEO Counselor at the agency where you work or where you applied for a job. Generally, you must contact the EEO Counselor within 45 days from the day the discrimination occurred. In most cases the EEO Counselor will give you the choice of participating either in EEO counseling or in an alternative dispute resolution (ADR) program, such as a mediation program.
  If you do not settle the dispute during counseling or through ADR, you can file a formal discrimination complaint against the agency with the agency's EEO Office. You must file within 15 days from the day you receive notice from your EEO Counselor about how to file. Once you have filed a formal complaint, the agency will review the complaint and, if the complaint is not dismissed for procedural reasons (e.g., because it was filed too late), the agency will conduct an investigation. The agency has 180 days from the day you filed your complaint to finish the investigation. When the investigation is finished, the agency will issue a notice giving you two choices: either request a hearing before an EEOC Administrative Judge or ask the agency to issue a decision as to whether the discrimination occurred.

For a detailed description of the federal complaint process, visit our website at www.eeoc.gov/federal/fed_employees/complaint_overview.cfm

Resources

Laws Protecting Veterans with Service-Connected Disabilities

ADA
U.S. Equal Employment Opportunity Commission (EEOC)
www.eeoc.gov
1-800-669-4000
1-800-669-6820 (TTY)

U.S. Department of Justice (DOJ)
www.ada.gov
1-800-514-0301
1-800-514-0383 (TTY)

USERRA
U.S. Department of Labor (DOL)
www.dol.gov/vets
1-866-4-USA-DOL
1-877-889-5627 (TTY)

VEVRAA
DOL, Office of Federal Contract Compliance Programs (OFCCP)
http://www.dol.gov/ofccp/regs/statutes/4212.htm
1-800-397-6251
1-877-889-5627 (TTY)

Recruiting and Hiring

National Resource Directory (NRD)
A partnership among the Department of Defense (DoD), Department of Veterans Affairs (VA), and DOL
www.nationalresourcedirectory.gov
1-800-342-9647

DOL One Stop Career Centers
www.careeronestop.org
1-877-348-0502
1-877-348-0501 (TTY)

Employer Assistance and Recruiting Network (EARN)
www.AskEARN.org
1-855-Ask-EARN (1-855-275-3276)

Occupational Information Network (O*NET) Online
Provides comprehensive occupational descriptions and data for use by job seekers, employers, and others
www.onetcenter.org/

U.S. Department of Veterans Affairs
www.va.gov
1-800-827-1000

U.S. Office of Personnel Management
www.fedshirevets.gov/
1-202-606-5090

Reasonable Accommodation

EEOC Enforcement Guidance: Reasonable Accommodation and Undue Hardship Under the ADA
www.eeoc.gov/policy/docs/accommodation.html

Job Accommodation Network (JAN)
www.askjan.org
1-800-526-7234
1-877-781-9403 (TTY)

DoD Computer/Electronic Accommodations Program (CAP)
www.tricare.mil/cap
1-703-681-8813
1-703-681-3978 (TTY)

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[1] See Title 38, United States Code § 101 (defining "service-connected" disabilities of military veterans).

[2] See Bureau of Labor Statistics, Employment of Veterans Summary (August 2015) available at http://www.bls.gov/news.release/vet.t08.htm.

[3] The EEOC also is responsible for enforcing federal laws that it make it illegal to discriminate against a job applicant or an employee (including a veteran) because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), or genetic information.

[4] 29 C.F.R. § 1630.2(j)(i)(1)(i)-(ii).

[5] 29 C.F.R. § 1630.2(j)(1)(ii)-(vii).

[6] 29 C.F.R. § 1630.2(j)(3)(iii).

[7] These provisions of VEVRAA are enforced by the Office of Federal Contract Compliance Programs (OFCCP) within the U.S. Department of Labor (DOL). See www.dol.gov/compliance/laws/comp-vevraa.htm

[8] Some states also grant veterans' preference for state government jobs. To find out if your state has a veterans' preference program, contact your state's labor office.

SOURCE: EEOC publication

Michigan Doctor Johnny Trotter Sentenced to 15 Years in Prison for $26 Million Health Care Fraud Scheme

Department of Justice

Office of Public Affairs

Nov. 7, 2017 - A Detroit-area doctor was sentenced to 180 months in prison today for his role in a $26 million health care fraud scheme that involved billing Medicare for nerve block injections that were never provided and efforts to circumvent Medicare’s investigation of the fraudulent scheme. A co-conspirator who owned a medical billing company was previously sentenced to 10 years in prison.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Daniel L. Lemisch of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office and Special Agent in Charge Manny Muriel of Internal Revenue Service Criminal Investigation (IRS-CI) made the announcement.

Johnny Trotter M.D., 42, of Bloomfield Hills, Michigan, was sentenced today by U.S. District Judge George C. Steeh of the Eastern District of Michigan. The owner of the medical billing company, Elaine Lovett, 61, of Detroit, was sentenced by Judge Steeh on Sept. 26. Judge Steeh also ordered each defendant to pay $9,199,946 in restitution and scheduled a hearing tomorrow on forfeiture. Trotter and Lovett were convicted in April 2017 after a four-week jury trial of one count of conspiracy to commit health care fraud and wire fraud, and three counts of health care fraud. Trotter was remanded to custody pending a detention hearing tomorrow.

According to the evidence presented at trial, from May 2008 until May 2014, Trotter and Lovett knowingly submitted fraudulent bills for services that they knew had not been provided, mainly nerve block injections. Additionally, after Medicare imposed a requirement in 2009 that required Trotter’s claims to undergo a medical review prior to payment, Trotter and Lovett conspired to circumvent Medicare’s fraud investigation of Trotter by creating sham medical practices, the evidence showed. To continue to receive payment for services that were not provided, Trotter and Lovett concealed their involvement with these practices from Medicare, and instead recruited their family members and employees to serve as straw owners of the companies, the evidence further showed.

The FBI, HHS-OIG and IRS-CI investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. Fraud Section Assistant Chiefs Malisa Dubal and Allan Medina, as well as Trial Attorneys Tom Tynan and Jacob Foster, prosecuted the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

https://www.justice.gov/opa/pr/michigan-doctor-and-owner-medical-billing-company-sentenced-15-years-prison-26-million-health

Illinois Service Dog Advocates Warn Against Passing Pets Off As Working Service Animals

Judy Peltier of Gurnee walks with her Seeing Eye dog, Janet, several times a week at the Independence Grove forest Preserve, where dogs are not allowed. (Frank Abderholden / Lake County News-Sun)

Article by Frank Abderholden for the Lake County News-Sun | Nov. 2, 2017                           

ILLINOIS - Freedom and Independence could be two good dog names, but for Judy Peltier of Gurnee, her Seeing Eye dog Janet literally gives Peltier her freedom and independence.

She wanted to make a point in the wake of October's blindness awareness month that service dogs serve a special need and people need to be aware of that, whether she is taking to task those "fake" service dog people or giving special thanks to all the people she crosses paths with while exercising three days a week at Independence Grove Forest Preserve in Libertyville, where dogs are not allowed as a rule.

"What's really great is that other fitness enthusiasts there understand, respect and support us as a guide-dog team," Peltier said.

"They don't interfere or obstruct," she said of her fellow walkers and runners at the forest preserve.

Peltier began going blind at age 5 with an inherited disease called retinitis pigmentosa, through which she lost her night vision first, then her day vision. Eventually, what sight she had became tunnel vision.

"All I see are silhouettes and no details," she said.

She got her first guide dog in 1999 and is now on her fourth, all of which were trained at The Seeing Eye in Morristown, N.J.

"You work with the dog for seven to eight years, and then you give them a good retirement," she said, which can mean adopting them out. "But I'm lucky I have a sighted husband (Tom) who loves to take my retired dogs," she said with a laugh.

"A guide dog offers enhanced mobility as opposed to using a white cane. It's just a choice to those who are legally blind," she said.

While she can see some shapes, her dog helps her navigate as it stops at crosswalks and for any change in the elevation, a step down or up, or something blocking her path entirely.

"Even doorways. They are trained to stop you when a car is pulling out of the driveway. These dogs take their final test in midtown Manhattan. These dogs are trained to save both our lives," she said.

"The mall is a great training ground," she said, which is where she walks in the winter. "The dog has to get you around strollers, kids running in and out of stores, kiosks with those little squeaky things," she said.

What she wants to remind people is that they should not act like she has a regular dog. In fact, she was reluctant to reveal Janet's name for that very reason.

"That's very critical. Sometimes people will start talking to the dog and distracting the dog. But, these dogs are to be ignored because they are working, and people need to know how to act," Peltier said.

And dog owners who try to pass their dogs off as service dogs prompts real scorn from Peltier, who has experienced unruly pets inside stores in the past.

"They were clearly not working dogs. They were barking and lunging at my dog," she said. "A service dog is trained to ignore other dogs. When people do that, it disrupts the work of the legitimate dog."

At The Seeing Eye training facility, dogs are taken to train stations, "so they feel the ground move, and (are) around traffic and loud noises so they become used to it," she said.

President and CEO, James A. Kutsch Jr. of The Seeing Eye dog training school, first established in 1929, says Peltier is right about giving a service dog space. Their organization kicked off a campaign recently to remind people not to disturb service dogs or let their dogs distract service dogs.

"Any poorly trained or poorly controlled dog can interfere with the effective use of service animals, and can jeopardize the safety of both the disabled handler and the service dog," said Kutsch, who has had Seeing Eye trained dogs since 1970.

He believes incidents where a dog barks and lunges in a business as putting the business owner in a bad situation, because people can use social media against the business.

"Businesses are put in a tough place and the general public needs to be educated. There needs to be an awareness," he said.

According to the Americans with Disabilities Act (ADA), business owners can ask a disruptive dog and owner to leave an establishment.

"If the general public understands that, then social media can be positive and the business gets approval and not condemnation from the public," Kutch said. "Businesses and the general public need to be more aware that they are not required to tolerate bad behavior from any animal, be it a fake or a legitimate service animal."

The only thing a business owner can ask a person with a service dog is, "What task is the dog trained to do to mitigate the disability?" he said.

Some politicians want to be able to certify dogs, but he is against that idea.

"There are many proponents of that solution. People with disabilities struggle enough that this just becomes an additional burden," he said. It's like every time you go to pull out of your driveway, you're asked for your driver's license, he added.

"A well-behaved dog doesn't bother me, whether it's a legitimate service dog or not," Kutsch said, but he's not encouraging people to try and pass off the family pet as a service dog.

"I personally think it's always been a problem," but media and legislative attention seems to "backfire," he said. "Look how easy it is. The general public says 'Why didn't I think of that.' And, as a result, we are seeing more of it," he said.

In fact, he warns against buying some package readily sold on the internet from $21.99 to $125 that offers training and an official looking harness, because the ADA does not require it.

"Everyone needs to remember the equipment doesn't make it legitimate. There is no way to tell by breed or size (they use three-quarter yellow Labrador and a quarter golden retriever for their dogs, which are specially trained for four months) to know if it's a service animal or not," Kutsch said.

"A dog for the blind is obvious, but dogs are trained to detect low blood sugar in diabetics and the onset of an epileptic seizure, and that can't be easily identified by the passerby," he said.

It boils down to good behavior can't be faked, and most family pets are out of their element, so his general message to anyone thinking about faking it is not to.

"Don't do it, because your dog is probably not prepared for the stress and it will misbehave. Don't do it, because you give a black eye to legitimate dogs and users who are trying to go about their daily life," he said.

Annie Thompson, spokeswoman for the Illinois Office of the Attorney General, said the ADA defines a service animal as any dog individually trained to provide assistance to a person with a disability, regardless of whether the animal is certified by a particular entity or wearing identifying markers.

"The Disability Rights Bureau enforces state and federal laws to ensure people with disabilities have equal access to their communities, and that includes educating businesses and the public about the importance of accommodating people who use service animals," she said in an email.

Individuals can contact the Disability Rights Bureau to file complaints or obtain additional information about service animals and other disability laws at 312-814-5684 in Chicago or 217-524-2660 in Springfield. The attorney general's link for ADA is at http://www.ag.state.il.us/rights/servanimals.html.

Kutsch offered this link for their effort to encourage the general public not to distract service dogs at https://www.guidedogatwork.org/. He also offered this link to the U.S. Department of Justice Civil Rights Division, Disability Rights Section, at http://www.ada.gov/regs2010/service_animal_qa.html.

Peltier said the Chicago-based Equip For Equality website is also helpful for people with disabilities at https://www.equipforequality.org/.

She recently recently did the five-mile Mackinaw Bridge walk in Michigan, where she and Janet carved through 25,000 participants without a hitch. No pet dogs were allowed.

"With hand on harness, this six-footed team has many more miles to roam and bridges to cross with freedom and independence," she said.

http://www.chicagotribune.com/suburbs/lake-county-news-sun/news/ct-lns-service-dogs-serious-work-st-1031-20171105-story.html

Justice Dept Settles with Montgomery County, MD, After School Programs to Ensure Compliance with the ADA

Oct. 10, 2017 - The Justice Department announced today that it reached an agreement with Bar-T Year Round Programs for Kids (Bar-T), located in Montgomery County, Maryland, to remedy alleged violations of the Americans with Disabilities Act (ADA).  Title III of the ADA prohibits public accommodations, including child care centers, from discriminating against individuals with disabilities and those associated with them.  Bar-T is the largest provider of before and after school programs in Montgomery County, operating at approximately 30 Montgomery County public school locations.    

The department investigated whether Bar-T discriminated against a student with a disability, specifically Autism Spectrum Disorder (ASD), and her parents when it expelled the student on the basis of behaviors associated with ASD, without properly considering whether Bar-T staff could implement reasonable modifications to permit the student to remain enrolled.  The settlement agreement requires Bar-T to adopt a nondiscrimination policy; designate staff at each operating location to address ADA issues; implement a process for parents or guardians of children with disabilities to request reasonable modifications and for Bar-T to conduct an individualized assessment of each request; provide ADA training to staff; and report on compliance with the agreement.  Bar-T will also pay $13,500 in compensatory damages to the student and her parents.

 “Through this agreement, Bar-T is taking important steps to make sure that all children in its programs, including children with disabilities, will be given the opportunity to have a positive and successful experience in a supportive after school environment,” said Acting Assistant Attorney General John Gore of the Civil Rights Division. 

 “Children with disabilities deserve equal opportunities to attend after school programs.  The policies Bar-T has agreed to implement will ensure that its programs provide an inclusive environment for all students,” said Acting United States Attorney for the District of Maryland Stephen M. Schenning.

To read the settlement agreement or for more information on the ADA, visit www.ada.gov.  For more information about the ADA, including how to file a complaint, call the Department’s toll-free ADA Information Line at 800-514-0301 (TDD 800-514-0383) or access the ADA website at www.ada.gov.

Attachment(s): 

Download Bar-T Settlement Agreement

Source: press release

Developmentally Disabled Patients Continue To Die Under State of Georgia Care

The state of Georgia continues to have developmentally disabled patients die while under state care, with 160 deaths in the past fiscal year, according to a court-appointed observer.

article by Tom Corwin for The Augusta Chronicle | Oct 7, 2017                                                      

The state often overlooks potential neglect or mistreatment uncovered by its own investigators, such as a woman who drowned in a bathtub this year, independent reviewer Elizabeth Jones said.

The U.S. Department of Justice sued Georgia over the conditions in its state hospitals, and the Georgia Department of Behavioral Health and Developmental Disabilities agreed to a settlement in 2010 that requires moving patients from state institutions to the most appropriate integrated setting, and to provide greater services and support for those patients in community settings. Jones is monitoring the state’s compliance with those provisions and reporting to the U.S. District Court in Atlanta on the state’s progress.

Site visits to current providers also found some are employing poorly trained and supervised staff. One patient, referred to only by the initials B.B., ended up hospitalized and recovering in a nursing home after she refused to eat and lost weight due to poor care in the home.

“The apparent indifference shown by the residential staff was equally disturbing,” Jones noted. With another patient referred to as J.B., the nurse consultant found the patient apparently heavily drugged, noting the man “was slouched down in the chair with his head hanging down” and had a black eye the staff could not explain.

An Augusta Chronicle investigation in 2015 found nearly 1,000 deaths in two years among patients in the community under the state’s care, and the state later agreed to a more robust system for investigating and reporting deaths. In fiscal year 2017, there were 160 deaths and 68 investigations, but “the findings and recommendations in certain investigations raise concerns about thoroughness, and, even more importantly, the legitimacy of the conclusions drawn from the investigation,” Jones wrote.

One glaring example is a patient known as C.Bi who drowned in her bathtub Feb. 17 despite a care plan that required caregivers to keep her in “line of sight at all times,” the report said. Yet there was no finding of neglect, Jones noted, despite reports that the staff had left the patient at other times to go to McDonald’s and “conflicting statements” from the staff about what they were doing that day.

“Multiple elements of this death are consistent with a finding of neglect,” Jones wrote. “It is disturbing that that conclusion was not reached.”

Some investigations are not completed yet, including one from January where “there was a concern about neglect” and another from June in a home where three patients have died since 2014. Jones wrote she “has identified five agencies that require additional, more intensive review due to the number or circumstances of unexpected deaths.”

The department would not answer detailed questions about her report, but said Jones “continues to provide reflections and recommendations that are valuable to DBHDD,” Press Secretary Angelyn Dionysatos said in a statement. “As we progress toward the end of the extension agreement, DBHDD is focused on sustaining the significant system gains that have been achieved and addressing remaining areas of required compliance.”

Because the state failed to meet its original deadline, the settlement agreement has been extended and the latest deadline is June 2018. As of June 30, there were 167 patients still in the Gracewood wing of East Central Hospital in Augusta and 366 developmentally disabled patients to be moved overall, according to Jones.

With the state moving 26 patients in fiscal year 2016 and 29 in fiscal year 2017, moving all of the patients to community settings “would take the state a dozen years or so,” she noted. A “substantial barrier” to those community placements is a lack of appropriate providers, but the state has failed to recruit a “single new provider” to provide care in those community settings since agreeing to a recruitment plan, Jones said.

Staff writer Sandy Hodson contributed to this report.

http://chronicle.augusta.com/news/2017-10-07/georgia-continues-see-developmentally-disabled-patients-die-under-state-care

City of New Albany, Indiana, to Resolve Disability Discrimination Federal Complaint

Oct. 4, 2017 - The Department of Justice announced that it reached an agreement with the city of New Albany, Indiana (New Albany), to resolve its lawsuit alleging that the New Albany Police Department and Merit Commission discriminated against an employee on the basis of his disability, in violation of the Americans with Disabilities Act (ADA).

The Justice Department’s complaint alleges that the New Albany Police Department and Merit Commission disclosed to the public and press an employee’s confidential medical information, which it had obtained through employment-related medical examinations and inquiries. The complaint further alleges that New Albany provided documents and information detailing the employee’s disability, prescription medications, medical care, and psychological evaluations to the press and that, as result of this unlawful disclosure, local press widely publicized the employee’s medical information.

Under the agreement, New Albany’s Police Department and Merit Commission will institute policies to keep confidential its employees’ medical information and procedures to effectively respond to employees’ complaints of unlawful disclosure of medical information. The City of New Albany will also ensure that Police Department and Merit Commission officials, supervisors, and personnel who have access to employees’ confidential medical information are fully trained in those policies. In addition, New Albany will pay $100,000 in compensatory damages to the employee.

“Under the ADA, employers have a legal responsibility to keep confidential their employees’ medical information.  This responsibility is critical to ensuring that employees with disabilities can work without fear of discrimination,” said Acting Assistant Attorney General John Gore of the Justice Department’s Civil Rights Division. “This agreement is another important step towards eliminating employment barriers for people with disabilities.”

“The unlawful disclosure in this case deprived an employee of his privacy and his dignity, causing him to endure public ridicule and emotional stress,” said U.S. Attorney Josh J. Minkler of the Southern District of Indiana. “We commend the City of New Albany for committing to changing its policies, training its staff, and compensating the employee.”

This matter was based on a referral from the Equal Employment Opportunity Commission’s Indianapolis District Office, which completed the initial investigation of the facts.

To read the settlement agreement, please find it here, and to read the complaint, please find it here. 

For more information on the Civil Rights Division, please visit www.justice.gov/crt. For more information on the Civil Rights Division’s Disability Rights Section, please call the department’s toll-free ADA Information Line at 800-514-0301 (TDD 800-514-0383) or visit www.ada.gov.

Source: Dept. of Justice press release

Dr. Roberto A. Fernandez of Miami Sentenced for Role in Pain Pill Diversion and $4.8 Million Medicare Fraud Scheme

Sept. 20, 2017 - A Miami physician was sentenced today to 97 months in prison and three years of supervised release, for his role in a $4.8 million health care fraud scheme that involved the submission of false and fraudulent claims to Medicare and the illegal prescribing of controlled substances, including oxycodone and hydrocodone.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office and Special Agent in Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.

Roberto A. Fernandez, M.D., 51, of Miami, was sentenced by U.S. District Judge Cecelia M. Altonaga of the Southern District of Florida.  Judge Altonaga also ordered Fernandez to pay $4.8 million in restitution, jointly and severally with his co-conspirators.  Fernandez pleaded guilty on July 11,  to one count of conspiracy to commit health care fraud and wire fraud in connection with a scheme, that ran from April 2011 to February 2017, involving the submission of false and fraudulent claims to Medicare and the illegal prescribing of controlled substances, including oxycodone, hydrocodone and alprazolam.

As part of his guilty plea, Fernandez admitted that he referred Medicare beneficiaries to pharmacy owners in exchange for illegal health care kickbacks.  Fernandez admitted knowing that the pharmacy owners were billing and receiving reimbursements from Medicare for prescription drugs based upon the prescriptions he sold, and that many of his prescriptions were medically unnecessary.  For example, he admitted providing prescriptions for expensive, name brand drugs, including HIV/AIDS medications that conflicted with other HIV drugs already prescribed to the beneficiaries.

Fernandez also solicited referrals of Medicare beneficiaries to his own practices from his co-conspirators, he admitted, including submitting claims to Medicare under his Part B provider number for services he did not, in fact, render.  Additionally, Fernandez admitted to receiving kickbacks in return for signing plans of care and prescriptions for medically unnecessary home health services.

Fernandez further admitted that he prescribed controlled substances, including addictive opioids, to patients and patient recruiters in return for $100 to $200 cash per prescription.  Fernandez admitted that he knew these patients did not need the controlled substances he prescribed, and that he would sometimes write prescriptions for controlled substances for patients whom he did not even examine. 

The FBI, HHS-OIG and USSS investigated the case, which was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.  Assistant U.S. Attorney Lisa H. Miller of the Southern District of Florida and a former Fraud Section trial attorney, and Fraud Section Trial Attorney Adam G. Yoffie are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

source: press release Department of Justice

New Orleans Woman Kim Ricard Convicted for Role in $2.1 Million Medicare Kickback Scheme

Sept 14, 2017 - A federal jury found a New Orleans woman guilty of conspiracy, identity theft and false statements charges for her role in an approximately $2.1 million Medicare kickback scheme.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Duane A. Evans of the Eastern District of Louisiana, Special Agent in Charge C.J. Porter of the Office of Inspector General – Health and Human Services Dallas Field Office and Special Agent in Charge Jeff Sallet of the FBI’s New Orleans Field Office made the announcement.

After a two-day trial, Kim Ricard, age 51, of New Orleans, was convicted of one count of conspiracy to pay and receive kickbacks in connection with Medicare beneficiaries. In addition, Ricard was convicted of three counts of accepting kickbacks, along with three counts of identity theft and one count of making false statements to federal agents. Sentencing has been scheduled for December 7, before U.S. District Judge Jane Milazzo of the Eastern District of Louisiana, who presided over the trial.

According to evidence presented at trial, from 2008 to 2013, Ricard and others engaged in a scheme to refer mentally ill Medicare patients to home health agencies in and around New Orleans, in exchange for kickbacks. The evidence further established that Ricard unlawfully used the Medicare identification information of three Medicare beneficiaries in connection with the scheme. Ricard then lied to investigators, the evidence showed.

As a result of the scheme, Ricard’s co-conspirator caused Medicare to pay over $2.1 million based on those illegally-obtained referrals

One other defendant was charged in this matter. Milton Diaz, 65, of Harvey, Louisiana, pleaded guilty and is awaiting sentencing.

This case was investigated by the Office of Inspector General of the Department of Health and Human Services, and the FBI. Trial Attorneys Claire Yan and Kate Payerle of the Criminal Division’s Fraud Section are prosecuting the case.

The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,500 defendants who have collectively billed the Medicare program for more than $12.5 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov

.source: press release Department of Justice